The role of epinephrine in CPR: A reappraisal

Charles W. Otto, Ronald W. Yakaitis

Research output: Contribution to journalArticlepeer-review

79 Scopus citations


Epinephrine is the recommended drug for use in resuscitation from all types of cardiac arrest. Experimental evidence has shown that the actions of epinephrine important for the restoration of spontaneous circulation are mediated by the alpha-adrenergic properties. The beta-adrenergic effects do not aid restoration of spontaneous circulation, nor do they aid defibrillation; however, beta-adrenergic stimulation does increase the oxygen consumption of the fibrillating myocardium, a potentially deleterious effect. The important factor in restoring spontaneous circulation appears to be development of adequate coronary blood flow by increasing coronary perfusion pressure (aortic diastolic minus right atrial pressure). Aortic diastolic pressure can be increased by any potent alpha-adrenergic agonist. Because phenylephrine and methoxamine do not have significant beta-adrenergic actions, they should be considered as alternatives to epinephrine for aid in restoring spontaneous circulation. Once spontaneous circulation is restored, alpha- and/or beta-adrenergic agonists may be needed for circulatory support. Which drugs will provide the best long-term survival has not been established.

Original languageEnglish (US)
Pages (from-to)840-843
Number of pages4
JournalAnnals of emergency medicine
Issue number9 PART 2
StatePublished - Sep 1984
Externally publishedYes


  • cardiopulmonary resuscitation
  • electromechanical dissociation
  • epinephrine
  • methoxamine
  • phenylephrine

ASJC Scopus subject areas

  • Emergency Medicine


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